C6/2008L A serious incident on the apron of Helsinki-Vantaa airport on 23 September 2008

A serious incident occurred on the apron of Helsinki-Vantaa airport on Tuesday 23 September 2008, at approximately 09:06. A ramp worker was exposed to the engine suction of a Finnair Embraer 170 airliner, registration OH-LEK. On 29.9.2008 Accident Investigation Board Finland appointed investigation commission C6/2008L to this incident. Air accident investigator Tii-Maria Siitonen was named investigator-in-charge, accompanied by investigator Tapani Vänttinen as a member of the commission.

The aircraft came to a stop at stand 127. The ramp worker, passing below the fuselage, went from the port side of the aircraft to the starboard side in order to place a plastic safety cone in front of the engine. However, the starboard engine was still running, thus exposing him to its suction. Engine suction ripped the safety cone from his hands and the hearing protectors off his head and into the engine. The ramp worker managed to escape the suction and was not hurt during the incident. Once the engine was inspected and cleaned it was flightworthy again. The aircraft’s red beacon lights were on.

The starboard engine of the incident aircraft was left on while the ground power cable was being coupled. The purpose of this was to avoid unnecessarily starting of the Auxiliary Power Unit. The investigation discovered several shortcomings in the ground handler’s organisation and management. Not all of the required reports for this incident had been filed. Site investigation found several superfluous objects on the apron. The investigation also revealed that the training syllabi of Northport Oy ramp workers do not meet Finnair’s minimum training requirements. Shortcomings were also found in the basic training of the ramp workers as regards occupational safety and human factors. Furthermore, the ramp workers’ training records were out of date.

The cause of the serious incident was the fact that the ramp worker entered the danger zone of a running jet engine. When he noticed that the port engine had spooled down he erroneously assumed that the starboard engine had also been turned off. Nor did he double-check that the aircraft’s red beacon lights were off, which indicate the engines are off. Contributing factors included lack of coordination between the airline and the ground handler, inadequate training and lack of supervision within the company as well as prevailing practices on the apron.

The investigation commission issued four safety recommendations. Northport Oy is advised to reevaluate its ramp worker training and bring the training records up-to-date. Finavia is advised to intensify its monitoring activities so as to ensure that ground handlers at the airport follow the rules and regulations on the safe use of equipment and removal of unnecessary foreign objects. Finnair is advised to confirm the completion of corrective action as regards non-conformances discovered during quality audits.

It was discovered during the investigation that Finavia had not audited Northport Oy in accordance with Aviation Regulation AGA M3-3. However, Finavia did begin to audit ground handlers during the spring of 2009.

C6/2008L Report (pdf, 0.61 Mt)